We think of the hands of an old man, imagining his teeth as if thin in the phalanges, but swollen in the joints. Few people think that this is not just a sign of natural aging of the body, but a sign of a real disease - osteoarthritis of the fingers. And what's more, not everyone knows that the disease can "age" hands in their twenties or thirties, which makes it a painful and difficult task to write a simple note or fold a glass lid. How to protect the fine motor skills of your fingers is at risk, and what to do with osteoarthritis of the fingers, if it started - read about it below.
Deformative arthrosis of the fingers
Because a person's metacarpophalangeal and interphalangeal joints experience a constant load, they must perform fine motor movements every minute for a normal quality of life - from simple dullness (take an apple, open a door, hold a knife blade) to a very small one. and complex ones (determine a person's handwriting, his ability to embroider and weave, his ability to play an instrument, and more). The more the fingers are loaded, the more wear is applied to the cartilage tissue that forms the joint surface and covers the heads of the phalangeal bones. This cartilaginous layer, washed with synovial fluid, allows the bones not to rub against each other as they move, as if slipping, and acts as a natural shock absorber (for example, during shock movements, without which it is impossible to type on the keyboard).
The phalangeal cartilage is subject to erosion for a variety of reasons, which we will discuss below. Often the process takes place as follows:
- Porous cartilage tissue undergoes a load in which the joint lubricant is "compressed" and provides good joint mobility. Normally, recovery occurs after this - the cartilage is re-saturated with moisture in a calm state. However, if the load is excessive or the cartilage nutrition is impaired, it begins to dry out and crack. This leads to a decrease in flexibility and functionality.
- Dry cartilage, which is unable to resist friction, gradually begins to wear out and thin out, opening the heads of the bones. Because the articular surface cannot fully cope with the task at hand, the bones, muscles, and ligaments begin to experience the load placed on the cartilage — almost all of the orthopedic apparatus of the finger, or even the entire hand. In order to increase the area of the joint surface and prevent further deletion, the body begins to "finish" osteophytes in the affected area - bone growths, which can be round or even spike-shaped. This process is popularly called "salt deposition", which is not entirely true, because we are talking about the proliferation of bone tissue.
- The appearance of osteophytes leads to a decrease in mobility - the fingers become more bent, and it is no longer possible to cope with normal daily tasks. At the same time, bone tissue does not have a protective mechanism against friction, and therefore osteophytes periodically break down and damage adjacent tissues, causing pain and inflammation. In addition, microscopic cracks form, which reduce the strength of the bone and make it brittle - so fractures of the fingers with osteoarthritis and osteoarthritis are not uncommon, even with very strong blows. When the osteophyte, which compensates for insufficient joint function, is broken, another grows in place - over time, the process only worsens with cartilage dysfunction.
- Severe wear of the joint surfaces, changes in the shape of the bones cause reconstruction of the whole hand, chronic inflammation and pain. The brush is so deformed that you can't even hold the mug with your finger.
Arthritis, also called osteoarthritis or osteoarthritis (all synonymous), is characterized by the destruction of the joint in the first place and the chronic course of the disease. Arthritis involves the presence of an acute inflammatory process that affects only the cartilage tissue. With osteoarthritis, the joint sac, synovium, subchondral bone, as well as ligaments and muscles are involved in the degenerative-dystrophic process. In addition, the pain with arthritis is generally sharp and severe, appearing at night. If osteoarthritis is felt during the day, in the early stages - very unexplained aching pains.
The most common forms of osteoarthritis are currently considered: rheumatoid arthritis involving the thumb and polyarthritis affecting several interphalangeal joints at the same time.
Remember: in the early stages of the disease, bone destruction can still be prevented, and osteoarthritis can lead to permanent remission while maintaining the high-quality biomechanics of the hands.
Causes of osteoarthritis of the small joints of the hands
The risk group often includes people with osteoarthritis in the fingers of the family. The density of cartilage tissue and the rate of metabolic processes within it are genetically predetermined, and therefore the predisposition to the development of the disease may be hereditary. In addition, the disease affects postmenopausal women about 10 times more than male peers.
The likelihood of osteoarthritis is associated with occupational and household burdens - typists, surgeons, masseurs, bakers, dairymen, turners and mills, pianists, athletes, and other professionals who "work with their hands" often experience unpleasant symptoms more quickly than others.
The development of osteoarthritis of the fingers is facilitated by:
- rapid erosion and / or insufficient regeneration of cartilage tissue;
- metabolic diseases, problems with the endocrine system, systemic autoimmune diseases (diabetes mellitus, rheumatoid arthritis, gout);
- lack of normal rest and warm-up at work, excessive exercise with dumbbells;
- sleep disorders and chronic stress;
- age-related hormonal changes;
- congenital hand defects;
- injuries to the hands, fingers and wrists;
- work with hypothermia, vibrating instruments and other unfavorable factors;
- septic and specific (tuberculosis, chlamydia, syphilis) infectious diseases;
- allergic reactions;
- chronic dehydration (habit of drinking less);
- An unbalanced diet without vitamins D, E, K and minerals.
Symptoms of arthrosis of the fingers
Symptoms and treatment of arthrosis of the finger joint can vary significantly depending on the stage of the disease and the patient's perception. Often, mild discomfort in the joints, increased muscle fatigue, and fatigue are ignored until persistent unbearable pain appears. However, the sooner treatment is started, the more complete the functionality of the fingers will remain in old age, and the higher the quality of life in the following years.
The first stage.The disease begins with pain in the hands, numbness or tingling, and sometimes manifests itself in shooting pains. It becomes more difficult to perform daily tasks - the fingers get tired faster, there is a dry and rough crisis in the joints (not to be confused with a "healthy" sound! ), Clicks while bending. I want to rest my hands. Pain is generally felt only during exercise. In a relaxed position, the fingers ache for a while and cause discomfort. The stiffness of the movements is becoming more and more noticeable, you need to "warm up" to stretch your fingers before exercises that require hand agility. The joints swell. When there is cardiovascular disease, the hands begin to respond to the changing air.
The second stage.At this stage there is a strong narrowing of the joint space (up to 50%), the inflammatory process increases. The skin on the joints is often hot. The pain is constant and can not stop at night. After work and in the morning there is swelling and stiffness of the fingers. The phalanges are noticeably thicker and the ligaments are shorter, the movements are rough, so it is more difficult to manipulate small objects (needles, strings, small coins and buttons). On the lateral parts of the joints, a characteristic thickening of the connective tissue (so-called Heberden and Bouchard nodes) filled with synovial fluid is seen - the cysts are especially noticeable when viewed from behind the palm. The tactile and heat sensitivity of the fingers is greatly reduced. It is almost impossible to relax your hands without a hot bath - the muscles are under constant tension. The amplitude of voluntary movements is significantly reduced, spasms are visible.
The third stage.In the final stages of the disease, the fingers are practically not bent, ankylosis and persistent contractures may appear. The pain is persistent, debilitating, and often causes depression in patients. Due to the dystrophy of the muscle tissue, the phalanges of the fingers between the joints become thinner. Even simple daily tasks - such as catching a cup - are practically inaccessible to the patient. He needs the help of others. Deformation of the joints and changes in the shape of the hand are clearly visible. In advanced cases, necrotic changes in the tissues are possible.
If you want to take an express test and find out if it is worth worrying about, an article on the symptoms and treatment of osteoarthritis will be useful for you. However, the best solution would be to contact a rheumatologist or orthopedist as soon as possible - only clinical diagnostic methods will help to finally confirm or refute the diagnosis.
Treatment of osteoarthritis of the fingers
Managing arthrosis of the fingers in the early stages allows you to completely eliminate the external symptoms of the disease, which affect the quality of life. However, the therapy is complex, multi-vector - it covers not only the use of drugs, but also physical effects and even occupational therapy. Fighting a chronic illness sometimes requires reconsideration of your diet, daily routine, working conditions, and workplace organization.
Drug treatment
Treatment of osteoarthritis of the fingers, as a rule, begins with pain relief, using immobilization of the hand with an atel or orthopedic bandage and analgesic tablets, creams and ointments. Rest helps hydrate the cartilage and restore its elasticity. When there is severe inflammation and edema that disrupts tissue trophism (nutrition), the doctor prescribes non-steroidal anti-inflammatory drugs (NSAIDs) that restore blood circulation in the fingers. Steroid hormones are prescribed according to the indications. Osteoarthritis caused by infectious arthritis requires topical administration of antibiotics.
The use of chondroprotectors has proven to be one of the most effective measures at any stage of the disease. Chondroitin sulfate and glucosamine should be consumed in courses of about 6 months a year - the effect is visible after a few months and is long-lasting.
If the proposed treatment does not relieve the pain, analgesics can be injected directly into the joint. Often, this procedure involves the use of special drug mixtures consisting of chondroprotectors, hyaluronic acid, platelet-rich blood plasma (PRP-therapy) and other means aimed at the restoration of cartilage tissue and the elimination of friction.
Surgical intervention for osteoarthritis of the hands
In the later stages of the disease, an operation can be performed according to the indications. Typically, this is joint washing and removal of osteophytes, reconstruction or formation of a destroyed joint, stabilization (fusion), or endoprosthetic (a procedure that has not been popular to date in surgery of the small joints of the hands).
Physiotherapy treatment
In most cases, the disease responds well to conservative physiotherapy - but only in remission after the inflammation has subsided. Devices for the treatment of deformed arthrosis of the fingers include electrophoresis, shock wave, UHF, pulse, magnetotherapy, etc. Acupuncture is also effective.
Therapeutic massage and self-massage are recommended to help patients cope with muscle tension and spasms, which have a beneficial effect on the condition of the joints, metabolism in the hands and fingers, as well as the amplitude of voluntary movements. Enough for self-massage:
- rub your palms together until the skin is warm;
- rub each finger from the base to the ends;
- move each finger in a small fist-like manner like sharpening a pencil;
- bend and flex your fingers at a speed of 30 seconds, avoiding fists;
- Bring your palms together and put your fingertips together, press well for 1-2 minutes.
Includes treatment of osteoarthritis of the fingers and gymnastics. Use rubber balls and special wrist expanders, special cubes and other devices to develop fine motor skills in the heat. Modeling from clay or plasticine is no more. This will help maintain muscle tone and prevent the formation of large osteophytes.
You can also take hot baths with water at home (you need to add sea salt, essential oils, herbal teas), paraffin or clean sand - heating the mixture will accelerate the removal of rotten products and provide rapid access to nutrients.
Diet for osteoarthritis of the fingers
Patients are advised to follow a non-strict diet, excluding smoked, very salty foods, alcohol, as well as foods that are artificially colored, steroids, preservatives. Diet is especially important in the treatment of metabolic osteoarthritis - it is completely determined by the attending physician. As a rule, patients are advised to eat foods rich in animal and plant collagen and other gelling agents. Meals should contain a minimum of "empty" calories and meet the body's daily needs for vitamins, macro and micronutrients. It is important to drink enough water with electrolytes, such as mineral or isotonic drinks.